Concerned about results 2 months into TRT - Advice Please

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S1W

Well-Known Member
I just got my results back after my first two months on TRT, and things are not perfect, which doesn't exactly surprise me based on the way I've been feeling.

Background: 39 year old male, fit/athletic, no other health issues prior to starting TRT (aside from those associated with low T - I had most of those issues).

Pre-TRT:

TOTAL T: 333 ng/dl (250-1100)
FREE T: 51.3 pg/dl (35-155)
FSH: 3.3 mIU/ml (1.7-8.6)
LH: 2.8 mIU/ml (1.5-12.4)

Those were all of the tests done before starting TRT, including several more total T tests, all of which came back on the low end of normal. I was prescribed 200mg/g (20%) compounded cream, and I have been applying 1/2g daily. No HCG, no AI.

Post-TRT:

TOTAL T: 795 ng/dl (264-916)
FREE T (DIRECT): 25.2 pg/ml (8.7-25.1) High
ESTRADIOL, SENSITIVE: 38.4 pg/ml (8-35) High
HEMOGLOBIN: 17.3 g/dl (13-17.7)
HEMATOCRIT: 50.5 % (37.5-51) (not flagged as high but close)
SHBG: 26.9 nmol/L (16.5-55.9)
TOTAL CHOLESTEROL: 203 mg/dl (100-199) High
HDL: 56 mg/dl (>39)
LDL: 122 mg/dl (0-99) High
PSA: 0.9 ng/ml (0-4)
LH: 0.1 mIU/ml (1.7-8.6) Low
DHEA: 337.3 ug/dl (102.6-416.3)
TSH: 2.080 uIU/ml (0.45-4.5)

Happy to provide more numbers for the various other tests that were run, but those are the highlights. My concerns are with hematocrit, estradiol, and cholesterol.

Experience:

I started out feeling amazing for the first few weeks. I have since heard this referred to on this board and elsewhere as the "honeymoon phase", and that sounds right to me. The next several weeks I would say that I felt moderately better than before TRT, but not as good as first few weeks. The last several weeks through present, I feel ok but hard saying if any better than pre-TRT. I noticed some fogginess, occasional low moods, mild discomfort around nipples that weren't there in the first few weeks - all of which I guessed even before seeing this may have been due to high E2.

My thoughts: as T levels increased, E2 increased and effectively offset any of the benefits I might have been feeling.

What thoughts or advice to you guys have on where to go from here? I'm in the process of switching to a more knowledgable TRT doc, but until then, I'd really appreciate any thoughts you guys might have.
 
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Guided_by_Voices

Well-Known Member
I don’t think you should be concerned about your cholesterol levels. Your HDL looks fairly good and you didn’t list trigs, so HDL to trig ratio can’t be calculated. But from everything I’ve studied, having high HDL, low trigs, low fasting insulin and reasonable a1c are what’s most important. If you are low carb, check out the site cholesterolcode for some good diet perspectives and analysis.
 

Vince

Super Moderator
Your numbers don't look back, it does that time to get dialed in. You could get a complete thyroid panel, just to be on the safe side.
 
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